Hello,
We are writing to
address some common concerns we have been hearing from you about Covid-19, this
Spring’s unwelcome guest.
Our goal here is to
provide some information about the illness itself, how to prepare, what to look
out for, how to manage illness symptoms, and how to interact with our office
and our greater community. It is our hope that this information will provide
some peace of mind. In this letter, we will be rendering some of our own
opinions about COVID-19, as well as relaying expert opinion and government
policy. Information is also available at www.coronavirus.gov . Here are some key starting points:
1. We
believe the death rate is less than what has been commonly reported and likely
under 1%. This is what has been shown in South Korea. Their death rate there
was 0.66% as of March 6. The reason their death rate is lowest is because South
Korea is doing a good job of identifying cases of COVID- 19 in people who have
mild illness by doing extensive testing. Other countries doing less testing are
only testing people who are really sick. People with mild illness are not being
detected or counted which falsely inflates the death rate. This means that
the vast majority of people who get this COVID-19 will recover.
2. The
hospitalization rate in China was reported to be 18%, we also believe this to
be inflated for the same reason, and in our opinion it is likely well under 10
%
3. The
purpose of social distancing and closures is to slow down the spread of this
illness so our hospitals do not get overwhelmed. If everyone gets this illness
quickly and all at once, there won’t be enough hospital beds and ICU beds to
manage the community’s needs.
4. Don’t
panic. Take reasonable precautions as recommended by infectious disease experts
and other people with expert knowledge on how to handle a pandemic. This will
allow us as a society to persevere through the problem with as little physical
and psychological toll as possible, and also make us stronger as a community
once this is behind us.
What can you do to
prepare yourself and your household from a medical point of view?
1. Follow
Department of Homeland Security advice regarding having a 2 weeks supply of
food and certain essential items on hand in case you are quarantined and can’t
get to the store. Unfortunately people have misunderstood this advice and have
been hoarding. This is not necessary, and creates needless panic. https://www.ready.gov/pandemic
2.
Where
possible have your prescriptions filled in 90 day increments, again, to have
enough in case you are quarantined. Drug makers have redundancies in their supply
chain. Shortages anytime soon are unlikely. We are accustomed to temporary
shortages of medicines even in normal situations in cases of manufacturing
problems (remember zantac?) and there are always workarounds. Again, don’t
panic here.
What should you do to
prevent illness in yourself and others?
1. Follow
the social distancing guidelines. Avoid family gatherings, worship from home,
try and stay 6 feet from others, avoid crowds, avoid shaking hands
2. Get
enough sleep: The immune system
functions best when you get 7-8 hours of sleep as an adult. Children need 9-11
hours per night depending on age.
3. Manage
stress properly: It is well known that
excess stress weakens the immune system. Engage in healthy stress relievers
that work for you.
4. Avoid
excess alcohol: Alcohol is known to
weaken the immune system. Our recommendation is to limit to 1 alcoholic unit
per day maximum. (1 unit is 12 oz. beer, 4 ¼ ounces of wine, or 1 ¼ ounces of
hard liqueur.)
5.
Avoid
touching your face.
6. Keep
your hands clean: Washing them when
needed, consider wearing gloves when touching frequently handled surfaces like
public door handles and shopping carts.
7.
If
you feel sick, even if it is a minor illness, STAY IN YOUR HOME. Do not leave
your house unless you need to get medical care. Stay in one part of your house
away from other family members.
8. Practice
good cough and sneeze hygiene by coughing into your arm or into a cloth or
tissue. Wash your hands if you cough into a tissue.
Which groups of
people are more vulnerable to COVID-19?
1. Much
like the flu, advanced age is a risk factor for death with COVID-19. Also
people with coronary artery disease and worse illness on presentation to the
hospital had higher risk of death. The CDC reports that after age 60 is when
death risk starts increasing.
2. In
a published study of a group of 191 people who were hospitalized, which is a
pretty small study, having high blood pressure and diabetes seemed to be risk
factors for hospitalization. Interestingly people with smoking related
lung disease were not statistically more likely to die or be
hospitalized. They did not assess for asthma. We think this study is
too small to generalize from.
3. Children
are much less likely to get sick from COVID-19 and it is unknown if they can
transmit it to others without being sick.
When you should
suspect COVID- 19?
If
you have temperature over 100 and a significant cough and . . .
1.
You
have close contact exposure to confirmed case of COVID- 19 or a Person Under
Investigation
2. You
should suspect it with a low grade fever and cough when other more common
illnesses like the flu are ruled out.
Who should get
tested?
1. The
health department will test people with symptoms who are close contacts of a
confirmed case, symptomatic cases at a long terms care facility (like a nursing
home) and symptomatic health care providers and anyone who is severely ill.
2. Call
the COVID-19 Screening hotline at 616-394-2080. This is available seven (7)
days per week 7:00 a.m. – 7:00 p.m.
What are some common
illnesses and diagnoses this year that people are asking about that are not
COVID-19?
1. Allergies:
We have had an early tree pollen season.
We are seeing lots of people with throat irritation, mucus production, throat
clearing and flares of known asthma. Some traits of seasonal allergies are
below:
a. Varying symptoms
depending on how much exposure you have to the outdoors, be it time outdoors or
open windows.
b. With allergies people
do not feel achy or feverish although some people can get fatigued in peak
pollen season.
c. If you are known to
have allergies or asthma this time of year before worrying about COVID- 19 try
allergy medications that normally would work for you.
d. Claritin, Allegra,
and Zyrtec are good for sneezing, runny nose, and post nasal drip
e. Flonase is good for
sinus pressure and stuffy nose but keep in mind it normally takes about 5 days
of daily use to kick in fully.
f. Prescription
azelastine works same day for stuffy nose and sinus pressure lasting about 12
hours.
g. If you have asthma
try an albuterol inhaler to see if symptoms improve temporarily. If they do,
then track how often symptoms occur. If they occur twice a week or more contact
us to work on a plan to control the asthma.
2.
The
common cold: Symptoms do not normally include a fever in adults, people feel
tired, run down, and usually have mild to moderate sore throat, with runny
nose, stuffy nose and mild cough.
a. It is possible that
COVID-19 can present like this in some people which is why you should practice
social distancing with even common cold symptoms, even though you yourself do
not need to be frightened.
3.
The
flu (Influenza): The flu is still
spreading widely in our area
a. Symptoms generally
come on strong and quickly where people get sick over the course of half a day
to one day. Symptoms are fever 101 or higher, body aches, chills, very run down
feeling, and mild cough. People feel like they have been hit by a truck.
b. These symptoms are
stronger than what is described as the initial presentation of COVID-19,
however people who have had a flu shot earlier in the season can get a watered
down version of the flu. This “watered down flu” could feel like a low grade
fever 100-101, mild cough, body aches and more mild fatigue than we typically
see.
4.
Getting
care when you are sick
a. If you are sick and
you are not sure what to do, you can obviously reach out to our office.
b. We will be trying to
handle more things by phone and portal to limit unnecessary spread of any kind
of illness to other patients, staff, and myself. If our staff or myself are
quarantined or get sick with COVID-19, our ability to help you will greatly
diminish or even be gone.
c. If you have symptoms
of a common cold we will not recommend coming into the office as it can be
managed at home. We will let you know what to expect in your recovery and what
to look out for that would indicate you need to be seen. Colds generally hit a
peak on day 4 and resolve by day 7-10. Sometimes they go on for 14 days.
d. If you have chest
symptoms we want you to be evaluated.
i. If the situation is
severe, like you have difficulty breathing or an outside observer notices that
you have difficulty breathing, then you need to go to the emergency room
ii. If it is during
business hours and symptoms are not severe enough for the ER, we will recommend
an appointment in the office.
iii. If it is after
business hours and symptoms are not severe enough for the ER, then you should
go to urgent care
e. Etiquette in the
office:
i. We will allow only
the patient in the office. One adult may accompany a child or disabled patient.
ii. We will have separate
hours for well visits and for sick visits.
iii. Wear a mask if you
have had temperature over 100 in the last 7 days (or felt a fever if you don’t
have a thermometer) or if you have a cough. We will provide one as long as we
still have them available.
iv. Please don’t offer a
handshake and we promise we won’t offer you one either.
v. Please do not request
extra supplies of medications beyond a 90 day supply. We won’t be able to do
this.
vi. Please do not request
antibiotics just to have on hand
vii. Please don’t call in
requesting antibiotics for colds. If you have had symptoms for only a few days
it is almost certainly NOT bacterial. It usually takes 10-14 days to develop a
bacterial infection unless one has an unusual underlying condition, which we would
have already talked about.
Thank you so much for making it to the end of
this long letter. We hope you find this helpful. And we hope it gives you some
peace of mind. We are all in this together and we will get through it!
LFM Physicians and Staff
